Citation Nr: 0908288 Decision Date: 03/06/09 Archive Date: 03/12/09 DOCKET NO. 04-24 554 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Oakland, California THE ISSUES 1. Entitlement to a compensable disability rating for service-connected allergic rhinitis. 2. Entitlement to a disability rating in excess of 10 percent for service-connected psoriatic arthritis, fingers left hand. 3. Entitlement to a disability rating in excess of 10 percent for service-connected psoriatic arthritis, fingers right hand. 4. Whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for a right elbow condition, and if so, entitlement to service connection for same. 5. Whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for a left elbow condition, and if so, entitlement to service connection for same. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD M. Purdum, Associate Counsel INTRODUCTION The Veteran served on active duty from December 1972 to October 1992. This matter comes before the Board of Veterans' Appeals (Board) from an August 2002 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) that denied the Veteran's claim of entitlement to service connection for left foot third toe arthritis, the Veteran's claim of entitlement to a compensable disability rating for service-connected allergic rhinitis, and the Veteran's claims of entitlement to disability ratings in excess of 10 percent each, for service- connected psoriatic arthritis, fingers right hand, and psoriatic arthritis, fingers left hand. The August 2002 rating decision also denied the Veteran's application to reopen his previously-denied claims of entitlement to service connection for low back degenerative joint disease, bilateral shoulder pain and stiffness, and right and left elbow conditions, on the basis that new and material evidence had not been submitted. The Board notes that the Veteran's Notice of Disagreement, dated in November 2003, disagreed with the August 2002 rating decision as to his claims of entitlement to service connection, increased disability ratings, and his application to reopen his previously denied claims of entitlement to service connection. An April 2004 rating decision granted the Veteran's claim of entitlement to service connection for arthritis, left toes. The April 2004 rating decision also reopened the Veteran's previously-denied claims of entitlement to service connection for right and left shoulder conditions, and granted service connection for synovitis, right arm, associated with cervical strain with degenerative joint disease and synovitis, left arm, associated with cervical strain with degenerative joint disease. A September 2008 rating decision reopened the Veteran's previously-denied claim of entitlement to service connection for a low back condition, and granted service connection for low back degenerative joint disease. Thus, the Veteran's claims of entitlement to service connection for arthritis, left toes; low back degenerative joint disease; radiculopathy and synovitis, left arm, associated with cervical strain with degenerative joint disease; and radiculopathy and synovitis, right arm, associated with cervical strain with degenerative joint disease, are no longer on appeal. FINDINGS OF FACT 1. Since November 8, 1999, one year prior to the date of the Veteran's claim of entitlement to a compensable disability rating for service-connected allergic rhinitis, the Veteran's service-connected allergic rhinitis has not been manifested by one or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting. 2. Since November 8, 1999, one year prior to the date of the Veteran's claim of entitlement to a disability rating in excess of 10 percent for service-connected psoriatic arthritis, fingers left hand, the Veteran's service-connected psoriatic arthritis, fingers left hand has not been manifested by an active process of rheumatoid arthritis, unfavorable or favorable ankylosis, or compensable limitation of motion. 3. Since November 8, 1999, one year prior to the date of the Veteran's claim of entitlement to a disability rating in excess of 10 percent for service-connected psoriatic arthritis, fingers right hand, the Veteran's service- connected psoriatic arthritis, fingers right hand has not been manifested by an active process of rheumatoid arthritis, unfavorable or favorable ankylosis, or compensable limitation of motion. 4. The Veteran's claims of entitlement to service connection for a left elbow and a right elbow disorder were previously denied in a December 1998 rating decision. The Veteran was notified of that decision but failed to perfect a timely appeal. The decision became final. 5. The evidence as to the Veteran's claims for service connection for left and right elbow disorders received since the last final denial in December 1998 is either cumulative or redundant, or does not bear directly and substantially upon the specific matter under consideration, and is not so significant that it must be considered in order to fairly decide the merits of the claims. CONCLUSIONS OF LAW 1. Since November 8, 1999, the criteria for a compensable disability rating for service-connected allergic rhinitis are not met. 38 U.S.C.A. §§ 1155, 5103, 5103A, 5107 (West 2002 & Supp. 2008); 38 C.F.R. §§ 3.321(b)(1), 4.7, 4.97, Diagnostic Codes (DCs) 6510, 6511, 6512, 6513, 6514 (2008). 2. Since November 8, 1999, the criteria for a disability rating in excess of 10 percent for service-connected psoriatic arthritis, fingers left hand are not met. 38 U.S.C.A. §§ 1155, 5103, 5103A, 5107 (West 2002 & Supp. 2008); 38 C.F.R. § 4.71(a), DCs 5002, 5216-5227 (as in effect prior to August 26, 2002); 38 C.F.R. §§ 3.321(b)(1), 4.7, 4.40, 4.45, 4.71(a), DCs 5002, 5216-5230 (2008). 3. Since November 8, 1999, the criteria for a disability rating in excess of 10 percent for service-connected psoriatic arthritis, fingers right hand are not met. 38 U.S.C.A. §§ 1155, 5103, 5103A, 5107 (West 2002 & Supp. 2008); 38 C.F.R. § 4.71(a), DCs 5001, 5216-5227 (as in effect prior to August 26, 2002); 38 C.F.R. §§ 3.321(b)(1), 4.7, 4.40, 4.45, 4.71(a), DCs 5002, 5216-5230 (2008). 4. The December 1998 rating decision that denied the Veteran's claims of entitlement to service connection for a left elbow disorder and a right elbow disorder is final. 38 U.S.C.A. §§ 5103, 5103A, 5107, 7105 (West 2002 & Supp. 2008); 38 C.F.R. §§ 3.104(a), 3.160(d), 20.302, 20.1103 (2008). 5. New and material evidence has not been received to reopen the Veteran's previously denied claims for service connection for left and right elbow disorders. 38 U.S.C.A. §§ 5103, 5103A, 5107, 5108 (West 2002 & Supp. 2008); 38 C.F.R. § 3.156(a) (2001). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Duties to Notify and Assist the Appellant As provided for by the Veterans Claims Assistance Act of 2000 (VCAA), the United States Department of Veterans Affairs (VA) has a duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2008); 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a) (2008). Upon receipt of a complete or substantially complete application for benefits, VA is required to notify the claimant and his representative of any information, and any medical or lay evidence, that is necessary to substantiate the claim. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b); Quartuccio v. Principi, 16 Vet. App. 183 (2002). Proper notice from VA must inform the claimant of any information and evidence not of record: (1) that is necessary to substantiate the claim; (2) that VA will seek to provide; and (3) that the claimant is expected to provide in accordance with 38 C.F.R. § 3.159(b)(1). This notice must be provided prior to an initial unfavorable decision on a claim by the agency of original jurisdiction (AOJ). Mayfield v. Nicholson, 444 F.3d 1328 (Fed. Cir. 2006). For an increased-compensation claim, section § 5103(a) requires, at a minimum, that the Secretary notify the claimant that, to substantiate a claim, the claimant must provide, or ask the Secretary to obtain, medical or lay evidence demonstrating a worsening or increase in severity of the disability and the effect that worsening has on the claimant's employment and daily life. See Vazquez-Flores v. Peake, 22 Vet. App. 37 (2008). Further, if the Diagnostic Code under which the claimant is rated contains criteria necessary for entitlement to a higher disability rating that would not be satisfied by the claimant demonstrating a noticeable worsening or increase in severity of the disability and the effect of that worsening has on the claimant's employment and daily life (such as a specific measurement or test result), the Secretary must provide at least general notice of that requirement to the claimant. The claimant must also be notified that, should an increase in disability be found, a disability rating will be determined by applying relevant Diagnostic Codes, which typically provide for a range in severity of a particular disability from noncompensable to as much as 100 percent (depending on the disability involved), based on the nature of the symptoms of the condition for which disability compensation is being sought, their severity and duration, and their impact upon employment and daily life. As with proper notice for an initial disability rating and consistent with the statutory and regulatory history, the notice must also provide examples of the types of medical and lay evidence that the claimant may submit (or ask the Secretary to obtain) that are relevant to establishing entitlement to increased compensation-e.g., competent lay statements describing symptoms, medical and hospitalization records, medical statements, employer statements, job application rejections, and any other evidence showing an increase in the disability or exceptional circumstances relating to the disability. VCAA notice errors are presumed prejudicial unless VA shows that the error did not affect the essential fairness of the adjudication. To overcome the burden of prejudicial error, VA must show: (1) that any defect was cured by actual knowledge on the part of the claimant; (2) that a reasonable person could be expected to understand from the notice what was needed; or, (3) that a benefit could not have been awarded as a matter of law. See Sanders v. Nicholson, 487 F.3d 881 (Fed. Cir. 2007). In this case, the RO sent the Veteran notice letters dated in January 2001 and October 2001 that provided examples of the types of medical and lay evidence that the claimant may submit (or ask the Secretary to obtain) that are relevant to establishing entitlement to increased compensation - e.g., competent lay statements describing symptoms, medical and hospitalization records, medical statements, Social Security determinations, and any other evidence showing an increase in the disability or the impact of the disability on employment. Vazquez- Flores, 22 Vet. App. 37 (2008). However, the Veteran was not informed of the specific criteria necessary for entitlement to a higher disability rating until July 2008, when the RO sent the Veteran a letter. Thus, in order to overcome the presumption of prejudice associated with this pre-adjudicatory notice error, the purpose of the notice must not have been frustrated. See Sanders, 487 F.3d at 889. In this case, the Board finds that the purpose of the notice was not frustrated. The Veteran's claim for an increased rating has been evaluated under Diagnostic Codes that provide for a higher rating upon evidence of a noticeable worsening or increase in severity of the disability. Vazquez-Flores, 22 Vet. App. 37. The Board notes that the Veteran was provided with applicable rating criteria at the time of the August 2002 rating decision, and in a April 2004 Statement of the Case, and has been provided VA examinations undertaken specifically to determine the current severity of his disabilities. Based on the various exchanges between the Veteran and VA with regard to his claims for increased ratings, the Veteran is reasonably expected to understand the types of evidence that would support his claims for increased ratings. In addition, as this case involves new and material evidence, VA is required to look at the bases for the prior denial and notify the Veteran as to what evidence is necessary to substantiate the element or elements required to establish service connection that were found insufficient at the time of the previous denial. The question of what constitutes material evidence to reopen a claim for service connection depends on the basis upon which the prior claim was denied. Kent v. Nicholson, 20 Vet. App. 1 (2006). The Board finds that the October 2001 pre-adjudicatory letter from the RO satisfied this requirement. More specifically, the Veteran was advised that his claim for an elbow disorder was previously denied in December 1998 and that in order to reopen the claim, he needed to submit medical evidence that substantiated that an elbow disorder was incurred in or aggravated by active military service. Also, a December 2006 VCAA letter also informed the Veteran regarding the appropriate disability rating or effective date to be assigned. See Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). As to VA's duty to assist, VA has associated with the claims file the Veteran's VA treatment records and afforded him VA examinations. The Board finds these actions have satisfied VA's duty to assist the Veteran and that no additional assistance is required. Smith v. Gober, 14 Vet. App. 227 (2000), aff'd 281 F.3d 1384 (Fed. Cir. 2002); Dela Cruz v. Principi, 15 Vet. App. 143 (2001). All relevant facts with respect to the claim addressed in the decision below have been properly developed. Under the circumstances of this case, a remand would serve no useful purpose. See Soyini v. Derwinski, 1 Vet. App. 540, 546 (1991) (strict adherence to requirements in the law does not dictate an unquestioning, blind adherence in the face of overwhelming evidence in support of the result in a particular case; such adherence would result in unnecessarily imposing additional burdens on VA with no benefit flowing to the Veteran); Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (remands which would only result in unnecessarily imposing additional burdens on VA with no benefit flowing to the Veteran are to be avoided). Increased Ratings Disability ratings are determined by the application of the VA's Schedule for Rating Disabilities. Separate diagnostic codes identify the various disabilities. 38 U.S.C.A. § 1155 (West 2002); 38 C.F.R. § Part 4 (2008). When rating a service-connected disability, the entire history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Ratings for service-connected disabilities are determined by comparing the Veteran's symptoms with criteria listed in VA's Schedule for Rating Disabilities, which is based, as far as practically can be determined, on average impairment in earning capacity. Separate diagnostic codes identify the various disabilities. 38 C.F.R. Part 4 (2008). Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7 (2008). Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance. It is essential that the examination upon which ratings are based adequately portray the anatomical damage, and the functional loss, with respect to all these elements. The functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective innervations, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. A little used part of the musculoskeletal system may be expected to show evidence of disuse, either through atrophy, the condition of the skin, absence of normal callosity or the like. 38 C.F.R. § 4.40 (2008). Evidence of pain, weakened movement, excess fatigability, or incoordination must be considered in determining the level of associated functional loss in light of 38 C.F.R. § 4.40, taking into account any part of the musculoskeletal system that becomes painful on use. DeLuca v. Brown, 8 Vet. App. 202 (1995). The provisions regarding the avoidance of pyramiding do not forbid consideration of a higher rating based on greater limitation of motion due to pain on use, including flare ups. 38 C.F.R. § 4.14 (2008). The provisions of 38 C.F.R. § 4.40 and 38 C.F.R. § 4.45 (2008), however, should only be considered in conjunction with the diagnostic codes predicated on limitation of motion. Johnson v. Brown, 9 Vet. App. 7 (1996). The intent of the rating schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59 (2008). With respect to the joints, the factors of disability reside in reductions of their normal excursion of movements in different planes. Inquiry will be directed to these considerations: (a) less movement than normal (due to ankylosis, limitation or blocking, adhesions, tendon-tie-up, contracted scars, etc.); (b) more movement than normal (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.); (c) weakened movement (due to muscle injury, disease or injury of peripheral nerves, divided or lengthened tendons, etc.); (d) excess fatigability; (e) incoordination, impaired ability to execute skilled movements smoothly; and (f) pain on movement, swelling, deformity or atrophy of disuse. Instability of station, disturbance of locomotion, interference with sitting, standing and weight- bearing are related considerations. 38 C.F.R. § 4.45. For the purpose of rating disability from arthritis, the spine is considered a major joint. 38 C.F.R. § 4.45. Arthritis shown by X-ray studies is rated based on limitation of motion of the affected joint. When limitation of motion would be noncompensable under a limitation-of-motion code, but there is at least some limitation of motion, a 10 percent rating may be assigned for each major joint so affected. 38 C.F.R. § 4.71a, Diagnostic Codes (DCs) 5003, 5010 (2008). For traumatic arthritis, DC 5010 directs that the evaluation of arthritis be conducted under DC 5003, which states that degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. 38 C.F.R. § 4.71a, DC 5010. When, however, the limitation of motion is noncompensable under the appropriate diagnostic codes, a rating of 10 percent may be applied to each such major joint or group of minor joints affected by limitation of motion. The limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. 38 C.F.R. § 4.71a, DC 5010. In the absence of limitation of motion, X-ray evidence of arthritis involving two or more major joints or two or more minor joint groups, will warrant a rating of 10 percent; in the absence of limitation of motion, X-ray evidence of arthritis involving two or more major joint groups with occasional incapacitating exacerbations will warrant a 20 percent rating. The above ratings are to be combined, not added under DC 5003. 38 C.F.R. § 4.71a, DC 5003, Note 1. The words slight, moderate, and severe as used in the various diagnostic codes are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all of the evidence, to the end that its decisions are equitable and just. 38 C.F.R. § 4.6 (2008). It should also be noted that use of terminology such as severe by VA examiners and others, although an element to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6 (2008). Increased Rating - Allergic Rhinitis The Veteran contends that he is entitled to a compensable disability rating for his service-connected allergic rhinitis. The disability is currently rated noncompensably under DC 6513. Under DC 6513, a noncompensable evaluation is assigned for sinusitis that is detected by an x-ray examination only. A 10 percent evaluation is warranted for one or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting. A 30 percent evaluation is warranted for three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting. A maximum 50 percent evaluation is warranted following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain, and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries. 38 C.F.R. § 4.97, DC 6513 (2008). An incapacitating episode is one which requires bedrest prescribed by a physician and treatment by a physician. Id., at Note. In addressing the applicability of other rating criteria pertaining to sinusitis, the Board finds that DC 6510 is not applicable, as the Veteran's condition has not been described as sinusitis, pansinusitis, chronic. 38 C.F.R. § 4.97, DC 6510 (2008). Similarly, DCs 6511, 6512, and 6514 are not applicable, as the Veteran's condition has not been described as sinusitis, ethmoid, chronic; sinusitis, frontal, chronic; or sinusitis, sphenoid, chronic. 38 C.F.R. § 4.97, DCs 6511, 6512, 6514 (2008). VA treatment records dated in May 2001 indicate that the Veteran complained of a headache. The Veteran reported that the pain was in the back of his head and in the center of his forehead, intermittently sharp and dull. The Veteran reported that his eyes were sensitive to light, and that he had a sore throat, and itching and watering eyes over the past two weeks. The Veteran reported a temperature, phlegm, and a runny nose. The Veteran was diagnosed with sinusitis and prescribed medication. Upon VA examination in May 2002, the Veteran complained of nasal congestion and sinusitis. The Veteran reported that his breathing was mildly congested and fluctuated from day to day. The Veteran reported that he required antibiotics once each year, and that the last treatment with such was one year prior. The Veteran reported that he took Dimetapp only. The Veteran reported that he used topical nasal steroid sprays in the past, with benefit. The examiner noted that the Veteran had not required surgery, nor had he undergone radiographical testing in anticipation of surgery. Physical examination revealed a normal tympanic membrane, bilaterally. The Veteran exhibited a mild right nasal septal deviation and a mild amount of intranasal edema without discharge or polyps. The Veteran's oral cavity was notable for two tonsils, an elongated uvula, and a low, soft palate. Hypopharynx was negative on indirect laryngoscopy, and the Veteran's vocal cords were normal. Palpation of the neck revealed no significant adenopathy. The Veteran was diagnosed with nasal allergies and only an infrequent episode of sinusitis, secondary to allergic rhinitis. VA treatment records dated in August 2004 indicate that the Veteran complained of a chronic cough that lasted two weeks and was productive of sputum, a low grade fever and chills. X-ray examination revealed normal anatomy. Upon VA examination in Janaury 2007, the Veteran complained of nasal congestion, all year-round, with a non-discolored runny nose, and an occasional frontal headache. The Veteran reported that he had never seen an ear, nose, and throat doctor for his condition, and that his last course of antibiotics was more than one year prior. The Veteran reported that he used over-the-counter medication, and that he rarely used prescription nasal sprays due to resulting nausea. Physical examination revealed clear ear canals, bilaterally, and normal tympanic membranes. Fiberoptic nasal endoscopy demonstrated that the septum was reasonably midline. The middle meati and sphenoethmoid recesses were clear, bilaterally. There was no evidence of edema, polyps, pus, or masses of either primary drainage pathway. There were no nasal abnormalities noted. The nasopharynx was clear, and examination the oral cavity, oropharnyx, and neck revealed normal results. In absence of symptoms or physical findings, the examiner did not provide a diagnosis. The examiner stated that he saw no evidence of sinus disease. As discussed above, 10 percent evaluation is warranted for allergic rhinitis if the symptomatology of same includes one or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting. In this case, the evidence of record does not support the conclusion that the Veteran's symptomatology of allergic rhinitis warrants a compensable disability rating, at any time since November 8, 1999. While the Veteran was treated with antibiotics on one occasion in May 2001, there is no evidence that such treatment was prolonged, lasting four to six weeks, or that he experienced an incapacitating episode. Further, there is no evidence that the Veteran experienced three to six non- incapacitating episodes in any one year, or that his symptomatology of allergic rhinitis included purulent discharge or crusting. Thus, there is no medical evidence of record indicating that the Veteran's symptomatology of service-connected allergic rhinitis warrants a compensable disability rating. Clearly, since a 30 percent rating requires even more frequent episodes, a 30 percent rating is not warranted, and the highest rating of 50 percent is not available as there is no evidence of relevant surgery or near constant symptoms. Instead, the evidence of record indicates that on four occasions in the past eight years, the Veteran reported symptomatology of allergic rhinitis including headaches, sensitivity to light, pain, phlegm, sore throat, itching and watering eyes, and congestion. Significantly, the most recent VA examination, dated in January 2007, was silent for any sinus disease. In sum, the Board finds that the Veteran's service-connected allergic rhinitis has warranted a noncompensable disabling rating since November 8, 1999, one year prior to the date of the Veteran's claim of entitlement to a compensable disability rating for service-connected allergic rhinitis. The Board has considered whether a higher rating might be warranted for any period of time during the pendency of this appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). However, there are no other applicable rating criteria that provide for a compensable disability. The preponderance of the evidence is against the claim of entitlement to a compensable disability rating for service- connected allergic rhinitis, and the claim must be denied. 38 U.S.C.A. § 5107(b) (West 2002); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Increased Rating - Psoriatic Arthritis, Fingers Left Hand and Psoriatic Arthritis, Fingers Right Hand The Veteran contends that he is entitled to disability ratings in excess of 10 percent each for his service- connected psoriatic arthritis, fingers left hand and psoriatic arthritis, fingers right hand. The disabilities are currently rated 10 percent disabling each under DC 5099- 5002. DC 5099 represents an unlisted disability requiring rating by analogy to one of the disorders listed under 38 C.F.R. § 4.71a. 38 C.F.R. § 4.27 (2008). DC 5002 contemplates rheumatoid arthritis as an active process. Under DC 5002, a 20 percent rating is warranted for rheumatoid arthritis as an active process, with one or two exacerbations a year in a well-established diagnosis. A rating of 40 percent is warranted for symptom combinations productive of definite impairment of health objectively supported by examination findings or incapacitating exacerbations occurring three or more times a year. A rating of 60 percent is warranted with weight loss and anemia productive of severe impairment of health or severely incapacitating exacerbations occurring four or more times a year or a lesser number over prolonged periods. A rating of 100 percent is warranted with constitutional manifestations associated with active joint involvement, totally incapacitating. 38 C.F.R. § 4.71a, DC 5002 (2008). For arthritis as chronic residuals, DC 5002 permits evaluation based on limitation of motion or ankylosis, favorable or unfavorable, of specific joints affected consistent with applicable rating criteria. Where, however, the limitation of motion of the specific joint or joints involved is noncompensable under the codes a rating of 10 percent is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under DC 5002. Id. Such limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Id. A Note to the Code provides that the rating for active process cannot be combined with that for residuals based on limitation of motion or ankylosis; the higher rating is to be assigned. 38 C.F.R. § 4.71a, DC 5002. The Board notes that the Veteran's service-connected psoriatic arthritis, fingers left hand and psoriatic arthritis, fingers right hand are currently assigned a 10 percent disability rating each under DC 5002. As discussed above, the minimum evaluation for rheumatoid arthritis under DC 5002 is 20 percent, for rheumatoid arthritis as an active process, with one or two exacerbations a year in a well- established diagnosis. Thus, the basis for the 10 percent disability ratings currently assigned to the Veteran's service-connected psoriatic arthritis, fingers left hand and psoriatic arthritis, fingers right hand is found under DC 5002 for chronic residuals of rheumatoid arthritis, for noncompensable limitation of motion for a group of minor joints. The rating criteria pertaining to impairment of the hand and fingers apply different disability ratings based upon whether the major or minor arm is affected. 38 C.F.R. § 4.71a, DCs 5216 through 5230 (2008). However, in this case, the only applicable rating criteria, the criteria pertaining to limitation of motion of individual digits, apply the same disability ratings to the major arm and minor arm. Thus, further inquiry as to the Veteran's major or minor arm is not required. During the pendency of the Veteran's appeal, VA promulgated new regulations concerning the evaluation of ankylosis or limited motion of single or multiple fingers, effective August 26, 2002. See 67 Fed. Reg. 48,784 (July 26, 2002) (codified at 38 C.F.R. pt. 4). If a law or regulation changes during the course of a claim or an appeal, the version more favorable to the Veteran will apply, to the extent permitted by any stated effective date in the amendment in question. 38 U.S.C.A. § 5110(g) (West 2002); VAOPGCPREC 3- 2000. See Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003); VAOPGCPREC 7-2003. The amendments above have established the effective dates without a provision for retroactive application. In an April 2004 Statement of the Case, the RO considered the new regulations and the new rating criteria were provided to the Veteran and his representative. Therefore, there is no prejudice to the Veteran by this Board decision. See Bernard v. Brown, 4 Vet. App. 384 (1993). Under the version in effect until August 26, 2002, DCs 5216 through 5227 were applied to unfavorable and favorable ankylosis of multiple fingers, and ankylosis of individual fingers. 38 C.F.R. § 4.71a, DCs 5216 through 5227 (as in effect prior to August 26, 2002). Under the current regulations, the version in effect as of August 26, 2002, DCs 5216 through 5227 are applied to unfavorable and favorable ankylosis of multiple digits, and ankylosis of individual digits. DCs 5216 through 5219 require consideration of whether evaluation as amputation is warranted DCs 5224 through 5227 require consideration whether evaluation as amputation is warranted and whether additional evaluation is warranted for resulting limitation of motion of other digits or interference with overall function of the hand. 38 C.F.R. § 4.71a, DCs 5216 through 5227 (2008). Also under the current regulations, the version in effect as of August 26, 2002, DCs 5228 through 5230 apply to limitation of motion of individual digits. 38 C.F.R. § 4.71a, DCs 5228 through 5230 (2008). With respect to limitation of motion of the thumb, DC 5228 applies where there is a gap of less than one inch between the thumb pad of the dominant hand and nondominant hand and the fingers, with the thumb attempting to oppose the fingers, and a noncompensable rating is assigned. Where that gap is one to two inches, a 10 percent rating is assigned to both the dominant and nondominant hand. Where that gap is more than two inches, a maximum 20 percent rating is assigned to both the dominant and nondominant hand. 38 C.F.R. § 4.71a, DCs 5228. With respect to limitation of motion of individual digits, DC 5229 applies where there is limitation of motion of the index or long finger of the dominant or nondominant hand with a gap of less than one inch (2.5 cm.) between the fingertip and the proximal transverse crease of the palm, with the finger flexed to the extent possible, and; extension is limited by no more than 30 degrees, a noncompensable rating is warranted. With limitation of motion of the index or long finger of the dominant or nondominant hand with a gap of one inch (2.5 cm.) or more between the fingertip and the proximal transverse crease of the palm, with the finger flexed to the extent possible, or; with extension limited by more than 30 degrees, a maximum 10 percent rating is warranted. 38 C.F.R. § 4.71a, DC 5229. DC 5230 applies to any limitation of motion of the ring or little finger, and warrants a noncompensable rating for both the dominant and nondominant hand. 38 C.F.R. § 4.71a, DC 5230. There is no medical evidence of record indicating that the any of the digits of the left or right hands are ankylosed. Significantly, a range of motion was provided for every joint of the digits of the left and right hands during multiple instances of treatment. Thus, the rating criteria, under the regulations in effect before and after August 26, 2002, contemplating ankylosis, favorable or unfavorable, are not applicable in this case. Also not applicable in this case are the requirements of DCs 5216 through 5227 as to consideration whether evaluation as amputation is warranted and whether additional evaluation is warranted for resulting limitation of motion of other digits or interference with overall function of the hand. Thus, the only rating criteria under which the Veteran may be assigned disability ratings in excess of 10 percent each for his service-connected psoriatic arthritis, fingers left hand and psoriatic arthritis, fingers right hand is DC 5228, pertaining to limitation of motion of the thumb, as DCs 5229 and 5230, pertaining to limitation of motion of the index, long, ring, or little fingers, provide a maximum 10 percent evaluation, the same evaluation currently assigned to the Veteran's service-connected psoriatic arthritis, fingers left hand and psoriatic arthritis, fingers right hand. 38 C.F.R. § 4.71a, DCs 5228, 5229, 5230. Turning to the evidence, the record before the Board contains VA treatment records, which will be addressed as pertinent. Dela Cruz v. Principi, 15 Vet. App. 143, 148-49 (2001) (a discussion of all evidence by the Board is not required when the Board has supported its decision with thorough reasons and bases regarding the relevant evidence). VA treatment records dated in August 2000 indicate that the Veteran appeared to have a fifth finger distal interphalangeal joint with swelling and erythema, tender to range of motion. VA treatment records dated in November 2000 indicate that the Veteran appeared to have sausage-shaped joint swelling, at the distal interphalangeal and proximal interphalangeal joints of the right hand. VA treatment records dated in March 2001 indicate that the Veteran appeared to have swelling of the metacarpophalangeal joints of the left hand, with decreased grip strength. The Veteran complained of worsening pain and swelling in the metacarpophalangeal joint of the right hand. The Veteran underwent x-ray examination of his hands. Results of such examination, compared with previous x-ray examination results, revealed deformity with reabsorption of the distal tufts of the left, first, second, and third fingers, and the right fifth finger. Minimal degenerative change was present at some of the distal interphalangeal joints. Additional VA treatment records dated in March 2001 indicate that the Veteran began occupational therapy. At that time, the Veteran reported that his hands felt worse, and that he noticed that he was dropping things more often, especially as to his left hand. The Veteran reported that his hands were stiff in the morning. The Veteran reported that his handwriting in the morning was bad, but that it improved in the afternoon. The Veteran reported that he did not have problems attending to the tasks of self care or cutting. The Veteran reported pain over the metacarpophalangeal joints of the left index finger and right thumb. The Veteran reported that he is a VA claims examiner, and that he types all day, including overtime work on the weekends. The Veteran reported that he takes two fifteen-minute breaks and has a 30-minute lunch. Range of motion testing of the Veteran's fingers of the left hand revealed the following: metacarpophalangeal joint of the index finger at 55 degrees; proximal interphalangeal joint of the index finger at 80 degrees; distal interphalangeal joint of the index finger at 40 degrees; metacarpophalangeal joint of the middle finger at 55 degrees; proximal interphalangeal joint of the middle finger at 95 degrees; distal interphalangeal joint of the middle finger at 55 degrees; metacarpophalangeal joint of the ring finger at 55 degrees; proximal interphalangeal joint of the ring finger at 100 degrees; distal interphalangeal joint of the ring finger at 50 degrees; metacarpophalangeal joint of the little finger at 80 degrees; proximal interphalangeal joint of the little finger at 90 degrees; distal interphalangeal joint of the little finger at 50 degrees; metacarpophalangeal joint of the thumb at 60 degrees; interphalangeal joint of the thumb at 55 degrees; palmar abduction of the thumb at 55 degrees; and radial abduction of the thumb at 55 degrees. Average grip strength score of the left hand was 24. Average lateral pinch score of the left hand was 14 and average three-point pinch score of the left hand was 10.3. Range of motion testing of the Veteran's fingers of the right hand revealed the following: metacarpophalangeal joint of the index finger at 70 degrees; proximal interphalangeal joint of the index finger at 95 degrees; distal interphalangeal joint of the index finger at 45 degrees; metacarpophalangeal joint of the middle finger at 75 degrees; proximal interphalangeal joint of the middle finger at 95 degrees; distal interphalangeal joint of the middle finger at 60 degrees; metacarpophalangeal joint of the ring finger at 75 degrees; proximal interphalangeal joint of the ring finger at 100 degrees; distal interphalangeal joint of the ring finger at 50 degrees; metacarpophalangeal joint of the little finger at 75 degrees; proximal interphalangeal joint of the little finger at 95 degrees; distal interphalangeal joint of the little finger at 50 degrees; metacarpophalangeal joint of the thumb at 50 degrees; interphalangeal joint of the thumb at 60 degrees; palmar abduction of the thumb at 50 degrees; and radial abduction of the thumb at 55 degrees. Average grip strength score of the right hand was 35. Average lateral pinch score of the right hand was 15.7 and average three-point pinch score of the right hand was 10. Physical examination revealed increased tenderness with palpation over the metacarpophalangeal joints of the left index finger and right thumb. The Veteran was diagnosed with rheumatoid arthritis, per his statements, which may have been limiting his range of motion and functional strength. The occupational therapist stated that education as to exercises and home treatments would be the focus of therapy. VA treatment records dated in April 2001 indicate that the Veteran worked with the VA occupational therapist to adjust his workstation and begin a home paraffin regimen. The Veteran presented with diminished light touch sensation to the left hand, and the middle, ring, and little fingers, and palm of the right hand. The Veteran was cautioned as to the use of hot and sharp objects. VA treatment records dated in May 2001 indicate that the Veteran was discharged from occupational therapy as to his hands, subsequent to exhibited improvement. The Veteran reported that his home paraffin unit was helpful, and that he made adjustments to his workstation. The Veteran reported that he had continued to work long hours, but that he had tried to take mini-stretch breaks. The range of motion testing of the Veteran's fingers of the left hand revealed the following: metacarpophalangeal joint of the index finger at 65 degrees, a 10 degree improvement; proximal interphalangeal joint of the index finger at 85 degrees, a 5 degree improvement; distal interphalangeal joint of the index finger at 45 degrees, a 5 degree improvement; metacarpophalangeal joint of the middle finger at 65 degrees, a 10 degree improvement; proximal interphalangeal joint of the middle finger at 100 degrees, a 5 degree improvement; distal interphalangeal joint of the middle finger at 65 degrees, a 10 degree improvement; metacarpophalangeal joint of the ring finger at 60 degrees, a 5 degree improvement; proximal interphalangeal joint of the ring finger at 100 degrees; distal interphalangeal joint of the ring finger at 55 degrees, a 5 degree improvement; metacarpophalangeal joint of the little finger at 70 degrees, a 10 degree decrease; proximal interphalangeal joint of the little finger at 85 degrees, a 5 degree decrease; distal interphalangeal joint of the little finger at 50 degrees; metacarpophalangeal joint of the thumb at 50 degrees; interphalangeal joint of the thumb at 45 degrees; palmar abduction of the thumb at 55 degrees; and radial abduction of the thumb at 60 degrees. Average grip strength score of the left hand was 45. Average lateral pinch score of the left hand was 12.7 and average three-point pinch score of the left hand was 10.3. The range of motion testing results of the Veteran's fingers of the right hand revealed the following: metacarpophalangeal joint of the index finger at 75 degrees, a 5 degree improvement; proximal interphalangeal joint of the index finger at 100 degrees, a 5 degree improvement; distal interphalangeal joint of the index finger at 45 degrees; metacarpophalangeal joint of the middle finger at 80 degrees, a 5 degree improvement; proximal interphalangeal joint of the middle finger at 90 degrees, a 5 degree decrease; distal interphalangeal joint of the middle finger at 60 degrees; metacarpophalangeal joint of the ring finger at 80 degrees, a 5 degree improvement; proximal interphalangeal joint of the ring finger at 95 degrees, a 5 degree decrease; distal interphalangeal joint of the ring finger at 50 degrees; metacarpophalangeal joint of the little finger at 80 degrees, a 5 degree improvement; proximal interphalangeal joint of the little finger at 95 degrees; distal interphalangeal joint of the little finger at 50 degrees; metacarpophalangeal joint of the thumb at 55 degrees; interphalangeal joint of the thumb at 55 degrees; palmar abduction of the thumb at 55 degrees; and radial abduction of the thumb at 60 degrees. Average grip strength score of the right hand was 48.3. Average lateral pinch score of the left hand was 15 and average three-point pinch score of the left hand was 10.3. VA treatment records dated in April 2002 indicate that the Veteran appeared to have boggysynovium at both proximal interphalangeal joints, without subluxation. Upon VA examination in July 2002, the Veteran reported that his psoriatic arthritis had worsened over the years. The Veteran reported that his fingers were more swollen, and that he had difficulty making a strong grip. The examiner noted, however, that the Veteran exhibited a full range of motion of the joints of the fingers, and was able to make a grip. The Veteran reported that he was able to use both of his hands for activities of daily living and for work, but that he experienced pain and morning stiffness. The Veteran also reported that the digits were rarely frank swollen or hard. Physical examination revealed that there appeared to be slight swelling around the interphalangeal joints of the fingers of both hands; however, there was no obvious redness or frank swelling. The Veteran's range of motion of all joints of the fingers, including the thumbs, was normal, bilaterally. The Veteran experienced some pain when the range of motion was pushed to the limit. The examiner reported that the Veteran had slight arthritic changes in both of his hands; however, he was able to use his hands functionally, and make a fist. VA treatment records dated in August 2003 indicate that the Veteran appeared to have mild swelling at the proximal interphalangeal and distal interphalangeal joints with sausage digits, and without joint subluxation. Treatment records dated in November 2003 indicate that the Veteran reported pain and a "tearing" sensation of pins subsequent to his January 2003 injury of falling off of a ladder. The Veteran reported that his swelling had improved and that he experienced "tingling" and numbness in his thumb. It appears that the Veteran underwent VA occupational therapy as to his wrists. During such treatment, the occupational therapist occasionally remarked upon the Veteran's fingers. In treatment records dated in December 2003, the Veteran exhibited range of motion as to the fingers of his right hand as follows: metacarpophalangeal joint of the index finger at 55 degrees; proximal interphalangeal joint of the index finger at 92 degrees; distal interphalangeal joint of the index finger at 55 degrees; metacarpophalangeal joint of the middle finger at 64 degrees; proximal interphalangeal joint of the middle finger at 93 degrees; distal interphalangeal joint of the middle finger at 62 degrees; metacarpophalangeal joint of the ring finger at 76 degrees; proximal interphalangeal joint of the ring finger at 101 degrees; distal interphalangeal joint of the ring finger at 48 degrees; metacarpophalangeal joint of the little finger at 76 degrees; proximal interphalangeal joint of the little finger at 98 degrees; and distal interphalangeal joint of the little finger at 64 degrees. In treatment records dated in January 2004, the Veteran exhibited range of motion of the left thumb of 37 degrees at the metacarpophalangeal joint, and 65 at the interphalangeal joint. In February 2004, the Veteran exhibited range of motion of the left thumb of 25 degrees at the metacarpophalangeal joint, and 70 degrees at the interphalangeal joint. In January 2004, the Veteran exhibited range of motion as to the fingers of his right hand as follows: metacarpophalangeal joint of the index finger at 70 degrees; proximal interphalangeal joint of the index finger at 101 degrees; distal interphalangeal joint of the index finger at 59 degrees; metacarpophalangeal joint of the middle finger at 77 degrees; proximal interphalangeal joint of the middle finger at 98 degrees; distal interphalangeal joint of the middle finger at 62 degrees; metacarpophalangeal joint of the ring finger at 82 degrees; proximal interphalangeal joint of the ring finger at 100 degrees; distal interphalangeal joint of the ring finger at 59 degrees; metacarpophalangeal joint of the little finger at 83 degrees; proximal interphalangeal joint of the little finger at 95 degrees; and distal interphalangeal joint of the little finger at 56 degrees. In February 2004, the Veteran exhibited full range of motion as to the fingers of his right hand. Upon VA examination in March 2004, for related conditions, the Veteran complained of pain that shoots from his neck down to the first three fingers of both hands. The examiner noted that the Veteran's hand grip was decreased in both hands, due to the Veteran's complaint of arthritis in his hands. The examiner reported that sensation was decreased to light touch in the index fingers, the thumbs, and both the volar surface and the dorsum of the hand. VA records dated in March 2006 indicate that the Veteran appeared to exhibit swelling in the left proximal interphalangeal and distal interphalangeal joints. Upon VA examination in December 2006, the Veteran reported increased pain as to his fingers. The Veteran reported that, due to his pain, he missed two days of work each month due to flare-ups. However, the Board notes that it is not entirely clear if the Veteran reported that he missed work due to flare-ups of pain as to his fingers, back, neck, or foot. The Veteran reported that he took over-the-counter medication, and that he was not on a prescription medication regimen for his inflammatory joint disease or chronic pains. The Veteran reported that he had difficulty lifting anything heavy, due to the pain in his hands. The Veteran claimed that he had some sensory impairment at the tips of some fingers of his hands. The examiner noted that no atrophy of the muscles was noted, and that numerous x-ray examinations failed to reveal any rheumatic disease. The examiner reviewed results of the March 2001 x-ray examination of the Veteran's hands. Physical examination revealed that the Veteran exhibited normal range of motion as to all joints of the fingers. No evidence of any inflammatory process around the joints of the fingers of either hand was noted. There was no local swelling, redness, puffiness, or rise in temperature noted. The examiner noted that the Veteran expressed pain with any range of motion of any joint, of any part of his body. The Veteran was diagnosed with history of psoriatic arthritis involving the joints of the fingers, without evidence of any active inflammatory process, with chronic pain. X-ray examination of the left hand revealed small erosive change of the inferior articulating surface of the distal phalanx on the radial aspect of the left middle finger. There was a possible mild erosive change of the ulnar aspect of the same distal interphalangeal joint of the left middle finger. The remainder of joint spaces appeared normal. The joint space widths appeared well-preserved throughout the hand region. There was no evidence of chondrocalcinosis, and no focal soft tissue swelling. X-ray examination of the right hand revealed that the distal interphalangeal joint and proximal interphalangeal joint of the right index finger demonstrated some joint space narrowing and mild irregularity of the articulating surfaces. The right fourth finger demonstrated mild joint space narrowing of the interphalangeal joints without any significant bony changes at the articulating surfaces. The middle finger demonstrated mild chondropathic joint space narrowing without significant degenerative changes of the articulating surface. The right index finger demonstrated some hypertrophic changes of the base of the distal phalanx of the index finger and mild joint space narrowing of the distal interphalangeal joint. The right thumb demonstrated irregularity of the articulating surface, mild marginal osteophytosis, and joint space narrowing of the interphalangeal joint of the thumb. The carpal-metacarpal joints all appeared within normal limits, and there appeared to be negative ulnar variance. The radiocarpal joint space was narrowed, with an interosseous cyst in the distal pole of the right navicular bone. The examiner considered the factors of DeLuca and indicated that the Veteran had pain with any motion of any joint of any part of his body. The examiner stated that there is no evidence of obvious inflammatory process by clinical examination, and past x-ray examination results do not show any evidence of any acute inflammatory disease. The examiner noted that there was evidence of past psoriatic arthritis in the hands. The examiner reported that the Veteran did not use any assistive devices and was completely independent in all activities of daily life. The examiner reported that the Veteran was able to drive and work, although he complained of pain. The examiner stated that the Veteran was able to manage his pain with some modifications and over-the-counter medication. VA treatment records dated in September 2007 indicate that the Veteran complained of index and middle finger pain at the distal interphalangeal joint of the left hand, index and middle finger pain at the distal interphalangeal joint of the right hand, and difficulty typing and opening bottles. X-ray examination revealed osteophyte formation and narrowing at the third distal interphalangeal joint joint and first inner phalangeal joint. Bony erosion was noted at the distal and dorsal third middle phalanx. Mild joint space narrowing and osteophyte formation was noted at the first metacarpophalangeal joint. Bony alignment was anatomic, and no fracture or abnormalities of the discrete soft tissues were noted. The Veteran was diagnosed with degenerative changes, which can be seen in psoriatic arthritis. As discussed above, the only rating criteria under which the Veteran may be assigned disability ratings in excess of 10 percent each for his service-connected psoriatic arthritis, fingers left hand and psoriatic arthritis, fingers right hand is DC 5230, pertaining to limitation of motion of the thumb. The medical evidence of record does not indicate that there is a gap of more than two inches (5.1 cm) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers, as is required for a 20 percent disability rating under DC 5230. 38 C.F.R. § 4.71a, DC 5230. The Board notes that the Veteran's treatment providers did not provide information as to the distance between the thumb pad and the fingers, with the thumb attempting to oppose the fingers. However, the Veteran, on instances of treatment dated in July 2002 and December 2006, exhibited normal range of motion as to the digits of his left hand. The Veteran exhibited normal range of motion as to the digits of his right hand in July 2002, February 2004, and December 2006. The Veteran reported, during instances of treatment dated in March 2001 and July 2002 that he had no difficulties with attending to the tasks of self care and daily living. The Veteran reported, during treatment dated in March 2002 that he typed all day at work, and worked overtime hours. The Veteran reported, during treatment in May 2001, that he continued to work long hours. The Veteran also reported, during treatment dated in July 2002, that he was able to use his hands for work. Treatment records dated in July 2002 indicate that the Veteran was able to make a fist and measurement of the Veteran's grip strength and ability to conduct a lateral pinch and three-point pinch test were unremarkable during treatment dated in March 2001 and May 2001, as to his left hand, and in March 2001, May 2001, December 2003, and January 2004, as to his right hand. The Board notes that during treatment dated in March 2001 and March 2004, the Veteran exhibited decreased grip strength. The Veteran reported, during treatment dated in December 2006 that he was able to drive. Because there is no medical evidence of record that the Veteran exhibited a gap of more than two inches (5.1 cm) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers, disability ratings in excess of 10 percent each for his service-connected psoriatic arthritis, fingers left hand and psoriatic arthritis, fingers right hand are not warranted under DC 5230. 38 C.F.R. § 4.71a, DC 5230. The Board has also considered whether an additional rating should be given for functional loss due to pain under 38 C.F.R. § 4.40 (including pain on use or during flare-ups) and functional loss due to weakness, fatigability, incoordination or pain on movement of a joint under 38 C.F.R. § 4.45. In this case, however, there is no medical evidence reflecting that any pain on use or during flare-ups, abnormal movement, fatigability, incoordination, or any other such factors results in the Veteran's fingers being limited in motion to the extent required for a rating under the limitation of motion code pertaining to the fingers. See 38 C.F.R. §§ 4.40, 4.45 (2008); De Luca v. Brown, 8 Vet. App. 202 (1995). In sum, the Board finds that the Veteran's psoriatic arthritis, fingers left hand and psoriatic arthritis, fingers right hand have each warranted a 10 percent disability rating since the November 8, 1999, one year prior to the date of the Veteran's claim of entitlement to disability ratings in excess of 10 percent. The Board has considered whether a higher rating might be warranted for any period of time during the pendency of this appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). However, there are no other applicable rating criteria that provide for a compensable disability. The preponderance of the evidence is against the claim of entitlement to disability ratings in excess of 10 percent each for service-connected psoriatic arthritis, fingers left hand and psoriatic arthritis, fingers right hand, and the claims must be denied. 38 U.S.C.A. § 5107(b) (West 2002); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Increased Rating - Conclusion Lastly, in reaching this decision, as to the Veteran's claims, entitlement to a compensable disability rating for service-connected allergic rhinitis, and disability ratings in excess of 10 percent each for service-connected psoriatic arthritis, fingers left hand, and psoriatic arthritis, fingers right hand, the potential application of various provisions of Title 38 of the Code of Federal Regulations have been considered, whether or not they were raised by the appellant, as required by the holding of the Court in Schafrath v. Derwinski, 1 Vet. App. 589, 593 (1991), including the provisions of 38 C.F.R. § 3.321(b)(1). The Board finds that the evidence of record does not present "an exceptional or unusual disability picture so as to render impractical the application of the regular schedular standards." 38 C.F.R. § 3.321(b)(1) (2008). In this case, there has been no assertion or showing by the appellant that his service-connected disabilities have necessitated frequent periods of hospitalization. While the appellant may assert that his disabilities have interfered with his employability, the evidence of record simply does not support a conclusion that any such impairment is beyond that already contemplated by the applicable schedular criteria. See Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993) (noting that the disability rating itself is recognition that industrial capabilities are impaired). In the absence of the factors set forth above, the Board finds that the criteria for submission for assignment of an extraschedular rating pursuant to 38 C.F.R. § 3.321(b)(1) are not met. See Bagwell v. Brown, 9 Vet. App. 337 (1996); Shipwash v. Brown, 8 Vet. App. 218, 227 (1995). New and Material Evidence- Left Elbow Disorder and Right Elbow Disorder Service connection for a left elbow condition and a right elbow condition was last denied in a December 1998. Although the RO declined to reopen the Veteran's November 2000 claims of entitlement to service connection for a left elbow condition and a right elbow condition, the Board must consider the question of whether new and material evidence has been received because it goes to the Board's jurisdiction to reach the underlying claims and adjudicate the claims de novo. Jackson v. Principi, 265 F.3d 1366 (Fed. Cir. 2001); Barnett v. Brown, 83 F.3d 1380 (Fed. Cir. 1996). If the Board finds that no such evidence has been offered, that is where the analysis must end, and what the RO may have determined in that regard is irrelevant. Barnet v. Brown, 83 F.3d 1380 (Fed. Cir. 1996). The claims of entitlement to service connection for a left elbow disorder and a right elbow disorder may be reopened if new and material evidence is submitted. Manio v. Derwinski, 1 Vet. App. 140 (1991). The Veteran filed this application to reopen his claims in November 2000. Under the applicable provisions, new evidence means existing evidence not previously submitted to agency decision makers. Material evidence means evidence that bears directly and substantially upon the specific matter under consideration, and which by itself, or in connection with evidence previously assembled is so significant that it must be considered in order to fairly decide the merits of the claims. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claims sought to be reopened. 38 C.F.R. § 3.156(a) (2001). The definition of new and material evidence has changed, and the latest definition only applies to applications to reopen a finally decided claim received by VA on or after August 29, 2001. Thus, the change does not apply to this case because the claim to reopen was received before that date. 66 Fed. Reg. 45,620 (Aug. 29, 2001); 38 C.F.R. § 3.156(a) (2005). In determining whether evidence is new and material, the credibility of the new evidence is presumed. Justus v. Principi, 3 Vet. App. 510 (1992). New evidence is sufficient to reopen a claim if it contributes to a more complete picture of the circumstances surrounding the origin of a Veteran's disability, even where it may not convince the Board to grant the claim. Hodge v. West, 155 F.3d 1356 (Fed. Cir. 1998). The evidence before VA at the time of the prior final decision in December 1998 included the Veteran's service treatment records for the period from December 1972 to October 1992, a prior rating decision dated in December 1994, and treatment records from Dr. Valdez dated in March and July 1997, and report of VA examination dated in June 1998. The Veteran applied to reopen his claims of entitlement to service connection for a left elbow condition and a right elbow condition in November 2000. Newly received relevant evidence includes VA treatment records for the period from December 1996 to the present and the Veteran's own statements. The Board, however, finds that the evidence as to the Veteran's claims for service connection for a left and right elbow disorder received since the last final decision in December 1998 is not material. The RO previously found that there was no medical evidence linking a current elbow disorder to service and the record still does not contain such evidence. Thus, the Board finds that the evidence submitted since the last final denial does not bear directly and substantially upon the specific matter under consideration, and by itself, or in connection with evidence previously assembled is not so significant that it must be considered in order to fairly decide the merits of the claims. Accordingly, new and material evidence as to the Veteran's claims for service connection for left and right elbow disorders has not been received, and such claims are not reopened. ORDER A compensable disability rating for service-connected allergic rhinitis is denied. A disability rating in excess of 10 percent for service- connected psoriatic arthritis, fingers left hand is denied. A disability rating in excess of 10 percent for service- connected psoriatic arthritis, fingers right hand is denied. Service connection for a left elbow disorder remains denied because new and material evidence has not been submitted to reopen the claim. Service connection for a right elbow condition remains denied because new and material evidence has not been submitted to reopen the claim. ____________________________________________ Michael J. Skaltsounis Acting Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs